Individual provider Active NPI

Frank G Laiacona, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Mount Shasta, CA
National Provider Identifier
1316389976
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
1953 Issued in HI
Practice address
914 Pine St
Mount Shasta, CA 96067-2143
Phone
(530) 859-2814
Fax
(530) 926-9306
NPI assigned
Jul 24, 2013
Last updated
Jul 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 17610 MA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 35608 CA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 1953 HI Primary

Addresses

Primary practice location

914 Pine St
Mount Shasta, CA 96067-2143

Mailing address

PO Box 1512
Mount Shasta, CA 96067-1512
Phone (530) 859-2814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
1953HIMDGeneral Practice Dentistry
35608CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
17610MAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1316389976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1512",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960671512",
            "telephone_number": "530-859-2814",
            "fax_number": "530-926-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-859-2814",
            "fax_number": "530-926-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIACONA",
        "first_name": "FRANK",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MA",
            "license": "17610",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "35608",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "HI",
            "license": "1953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Shasta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.